"The Optimal Dose of Vitamin D Based on Natural Levels"
If everyone took 2,000 units of vitamin D a day, it could shift the curve
from average blood levels in the mid-50's to about a 110,
which some estimate could add years to our life expectancy.
Data derived from randomized clinical trials have convinced some influential
experts, such as Harvard's chair of nutrition, that we should shoot
for this kind of range, levels that about 9 out of 10 people fail to reach
because it may necessitate taking between 1,800 and 4,000 units a day.
The Institute of Medicine, however, considered blood levels of 50
to be sufficient, and therefore only recommended 600 to 800 units a day
for those with little or no sun exposure
because they were only considering bone health.
But even if you just cared about your bones and not your lifespan
you'd still probably want to shoot for the 75 threshold
because there's evidence like this from hundreds of autopsies of people
that like died in car accidents showing osteomalacia, softening of the bones,
in between 18 to 39 percent of people that reach the Institute of Medicine target,
but fail to make it to 75.
There's even been a charge that the Institute of Medicine
simply just made a mistake in their calculations, and so using their own criteria
they should be recommending thousands of units a day as well.
But the mere absence of soft bones can hardly be considered
an adequate definition either of health or of vitamin D sufficiency.
It's like saying you only need 10 mg of vitamin C to avoid scurvy ---
yeah, but we need way more than that for optimal health.
The Institute of Medicine took the position that the burden of proof
fell on anyone who claimed benefits for intake higher
than their minimal recommendations, which is a good approach for drugs;
for unnatural substances less is more until proven otherwise.
But for nutrients, shouldn't the starting point, at least, be the natural levels
to which our bodies have become finely tuned over millions of years?
The target level of 75 only sounds high compared to average levels today,
but in modern times we practice unnatural activities
like working at a desk job, or sometimes even wearing clothes.
We evolved running around naked in equatorial Africa getting sun all day long.
If you measure vitamin D levels in those living traditional lives
in the cradle of humanity, a normal vitamin D level would be over 100.
So maybe that should be the starting point, until proven otherwise;
a concept, regrettably, many guidelines committees seem to have ignored.
Now look, the natural level isn't necessarily the optimal level,
and maybe the body would have thrived with less,
so you still have to look at what levels correspond to the lowest disease rates.
And when you do, the highest levels do indeed seem to correlate with less disease.
You know it always struck me when I was doing pediatrics
that breastfed babies required vitamin D drops.
I mean shouldn't human breast milk be a perfect food?
Of course for the medical profession the solution is simple:
provide the baby supplements, the drops, but it seems like we shouldn't have to.
It should be perfect. But, look, you measure
human breast milk these days and it has virtually no vitamin D
and would cause rickets, unless the mom had vitamin D levels up around -
you guessed it - the level natural for our species,
which of course makes total sense.
So it's just like an environmental mismatch the way we live in our modern world.
It helps to think of vitamin D as what it truly is, a hormone, not a vitamin.
So if you think of it like that, then it would be reasonable to have normal levels.
We physicians try to maintain blood pressure
and all sorts of parameters within normal limits,
but why is so little attention is paid to the status of the hormone "vitamin D"?